Provider Demographics
NPI:1609901818
Name:STEPHENSON, LINDA (RN)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 560066
Mailing Address - Street 2:
Mailing Address - City:SCIPIO
Mailing Address - State:UT
Mailing Address - Zip Code:84656
Mailing Address - Country:US
Mailing Address - Phone:435-743-5723
Mailing Address - Fax:435-896-4353
Practice Address - Street 1:50 SOUTH 400 WEST
Practice Address - Street 2:
Practice Address - City:FILLMORE
Practice Address - State:UT
Practice Address - Zip Code:84631
Practice Address - Country:US
Practice Address - Phone:435-743-5723
Practice Address - Fax:435-743-5723
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT196646-3102163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health